Featured Research

Thousands of men facing surgical removal of the prostate due to cancer may someday have one less thing to worry about: post-surgical urinary incontinence. That's because a team of expert urologic surgeons has devised a simple, effective means of reconstructing key anatomical structures that ensure continence.

Related Articles

That's because a team of expert urologic surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center has devised a simple, effective means of reconstructing key anatomical structures that ensure continence.

They describe the success of the procedure in the journal Urology. "Modifying existing tissues, our technique added only a few minutes to standard robotic prostatectomy, yet attained a 95 percent continence rate among patients 16 weeks after their surgeries," explains lead researcher Dr. Ashutosh K. Tewari, director of robotic prostatectomy and outcomes research at NewYork-Presbyterian/Weill Cornell and the Ronald P. Lynch Associate Professor of Urologic Oncology at Weill Cornell Medical College.

"This is a real breakthrough in prostate cancer care, as a significant number of patients have post-prostatectomy urinary incontinence," adds senior researcher Dr. E. Darracott Vaughan, attending urologist at NewYork-Presbyterian/Weill Cornell and The James J. Colt Professor of Urology at Weill Cornell Medical College. He is also Weill Cornell's senior associate dean for clinical affairs.

"Too often, the threat of incontinence can be a key factor in a patient's decision for or against prostatectomy," Dr. Vaughan adds. "A simple intervention like this could make that choice a lot easier."

Prostatectomy involves the excision of the prostate gland, as well as some adjacent tissue, depending on the extent and aggressiveness of the tumor. "Unfortunately, this can weaken structures that control the retention and release of urine from the bladder, such as the puboprostatic ligaments, related muscle and other key anatomy," Dr. Tewari explains. "Together, these structures form a kind of sphincter that must remain strong and supported to maintain urinary continence."

Numerous attempts have been made to modify prostatectomy and preserve continence, but none have proven ideal. Trying to find a better way, Drs. Tewari and Vaughan reviewed 3-D videos that detailed the urological anatomy of patients who had retained full continence after prostatectomy. "We were trying to figure out what went right in those cases," Dr. Vaughan says.

Armed with those insights, they devised the new technique, modeling it first in cadaver tissues. They then tested the new procedure in 50 consecutive patients scheduled to undergo robot-guided prostatectomy for the treatment of localized prostate cancer.

The procedure added just two to five minutes to the standard prostate-removing operation.

"Our technique uses tissues that would normally remain behind after prostatectomy — tissues that we can flip around and support to our advantage," Dr. Tewari explains. "We reconstruct the anterior and posterior parts of the sphincter and surgically join the bladder and the anastomosis (the gap in tissues left by prostatectomy) with the surrounding structures. In doing so, we reconstruct the major anatomical players controlling urinary continence."

The post-surgical results were impressive. One week after patients first had their urinary catheters removed, 29 percent were already fully continent; by six weeks, that figure rose to 62 percent; by eight weeks, 88 percent of the men were fully continent; and by 16 weeks, 95 percent had achieved continence.

The researchers stressed that the men involved in the study had all been diagnosed with non-aggressive, localized cancers. "With more aggressive tumors, surgeons must often excise the tissues that we need for reconstruction, so the technique is not useful in those cases," Dr. Vaughan says.

"But those cases are relatively uncommon, so most patients who undergo prostatectomy stand to benefit from the procedure," says co-author Dr. Alexis Te, director of the Brady Prostate Center at NewYork-Presbyterian/Weill Cornell and associate professor of urology at Weill Cornell Medical College.

"The technique entails no extra cost and very little added time in the OR, although surgeons would have to be trained, of course," Dr. Tewari says. "We're confident the procedure will enhance post-prostatectomy recovery, sparing men the significant loss in quality of life that chronic urinary incontinence can bring."

The Urology study was funded by the Ronald P. Lynch Oncologic Endowment and the Brady Urologic Research Foundation at Cornell University. Dr. Tewari is the principal investigator of a separate research study supported by Intuitive Surgical, Inc., makers of the da Vinci Surgical System, the surgical robot used in the current study.

More From ScienceDaily

More Health & Medicine News

Featured Research

Mar. 30, 2015  Neuroscientists are taking inspiration from natural motor control to design new prosthetic devices that can better replace limb function. Researchers have tested a range of brain-controlled devices ... full story

Mar. 30, 2015  Scientists have found the genetic signature of enterovirus D68 in half of the California and Colorado children diagnosed with acute flaccid myelitis -- sudden, unexplained muscle weakness and ... full story

Mar. 30, 2015  The first study to investigate the relationship between eating fruit and vegetables containing pesticide residues and the quality of men's semen has shown a link with lower sperm counts and ... full story

Mar. 30, 2015  Date syrup – a thick, sweet liquid derived from dates that is widely consumed across the Middle East – shows antibacterial activity against a number of disease-causing bacteria, including ... full story

Mar. 30, 2015  For many, body odor is an unfortunate side effect of their daily lives. The smell is caused by bacteria on the skin breaking down naturally secreted molecules contained within sweat. Now scientists ... full story

Mar. 30, 2015  Patients with chronic myelomonocytic leukemia have limited treatment options, and those that exist are effective only in fewer than half of patients. Now, a new study identifies a panel of genetic ... full story

Mar. 30, 2015  Researchers have produced 3-D maps of molecular and microbial variations across the body. These maps provide a baseline for studies of the interplay between the molecules that make up our skin, our ... full story

Mar. 30, 2015  Researchers combed through more than 50 years of medical records on hundreds of lemurs for clues to their longevity. They found that how long these primates live and how fast they age correlates with ... full story

Mar. 30, 2015  To help scientists make sense of 'brain big data,' researchers have used data mining to create www.neuroelectro.org, a publicly available website that acts like Wikipedia, indexing physiological ... full story

Mar. 30, 2015  The moon does not influence the timing of human births or hospital admissions, a new study finds, confirming what astronomers have known for decades. The study illustrates how intelligent people ... full story

Featured Videos

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015)  The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports.
Video provided by Reuters

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015)  Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline.
Video provided by Washington Post

S. Leone in New Anti-Ebola Lockdown

AFP (Mar. 28, 2015)  Sierra Leone imposed a three-day nationwide lockdown Friday for the second time in six months in a bid to prevent a resurgence of the deadly Ebola virus. Duration: 01:17
Video provided by AFP

Related Stories

Aug. 27, 2013  Patients with a diagnosis of dementia have approximately three times the rate of diagnosis of urinary incontinence, and more than four times the rate of fecal incontinence, compared with those ... full story

Aug. 8, 2011  Nearly half of men undergoing surgery for prostate cancer expect better recovery from the side effects of the surgery than they actually attain one year after the operation, a new study ... full story

Jan. 11, 2011  For men with incontinence for at least one year following radical prostatectomy, participation in a behavioral training program that included pelvic floor muscle training, bladder control strategies ... full story

Aug. 2, 2010  Stress urinary incontinence is one of the most feared complications of radical prostatectomy. The weighted mean continence rate immediately after catheter removal following robot-assisted ... full story

ScienceDaily features breaking news and videos about the latest discoveries in health, technology, the environment, and more -- from major news services and leading universities, scientific journals, and research organizations.